Health Related Social Needs (HRSN), such as food insecurity, housing quality, and access to transportation, are key drivers of persistent and increasing health disparities. Unmet HSRN are disproportionately prevalent in immigrant communities compared to U.S. born counterparts. Hispanic/Latinx families experience twice the rate of food insecurity than non-Hispanic/Latinx families with higher rates among immigrant Latinx populations. Despite the existence of evidence-based interventions to address food insecurity, health disparity populations have often not benefited from such interventions because either necessary adaptations have not occurred or have not been well-documented or evaluated. This career development award leverages an existing clinic- community collaboration, the Lawrence Mayor's Health Task Force, to develop an implementation strategy to increase enrollment in the Supplemental Nutrition Assistance Program (SNAP, also known as food stamps) among a multicultural Latinx immigrant community. SNAP enrollment will serve as a prototype evidence-based intervention to identify core community-driven strategies that can be used to adapt and implement additional evidence-based social interventions. This proposal uses robust community-engaged research and implementation science methods to identify and leverage community strengths to increase SNAP enrollment and expand the science of implementing evidence-based interventions in diverse communities. To do so, Dr. Byhoff proposes a career development program that blends rigorous methodologic training with an innovative research agenda. This plan has three scientific objectives: 1) to conduct a formative evaluation to understand stakeholder perceptions of food access, food programming, and SNAP utilization in a multicultural Latinx immigrant community; 2) to develop an implementation strategy using the Practical Robust Implementation and Sustainability Model (PRISM) framework and community engaged research methods to increase SNAP enrollment; and 3) Pilot a SNAP enrollment strategy and identify the essential components for a successful social intervention implementation among a multicultural Latinx immigrant community. In addition to advanced training through formal coursework, this career development award is supported by an extraordinary mentorship team, including internationally-recognized experts in health disparities research, community- engaged research methods, and implementation science. The combination of formal training and mentored research outlined in this application is designed to ensure that Dr. Byhoff will emerge from this award as an independent health disparities investigator with expertise in community-engaged research and implementation science methods.

Public Health Relevance

/Public Health Relevance: Hispanic/Latinx families, especially immigrants, experience twice the rate of food insecurity than non- Hispanic/Latinx families which contributes to disproportionate health disparities. Evidence-based food insecurity interventions, such as the Supplemental Nutrition Assistance Program (SNAP, also known as food stamps), have been demonstrated to improve mental and physical health outcomes for individuals facing food insecurity, yet is an under-utilized program especially among Latinx immigrant communities. The proposed research will develop a SNAP enrollment intervention as a prototype that will advance our understanding for how to identify community-driven strategies for implementing evidence-based social interventions across diverse communities.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Mentored Patient-Oriented Research Career Development Award (K23)
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Special Emphasis Panel (ZMD1)
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Alvidrez, Jennifer L
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Tufts University
United States
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